SOP 104.58-att-8: Drug Test Awareness Statement/Notification (Pre-Employment)

Division:
Administrative & Finance
Effective Date:
August 19, 2020
Topic Area:
104 Policy-HR Appearance/Conduct/Evaluations
PowerDMS:
View on PowerDMS
Length:
220 words

Summary

This form notifies job applicants that their employment offer is conditional upon passing a drug test. It explains that an initial on-site drug test will be conducted, and if results are inconclusive, the sample will be sent to an independent lab for confirmation. The form warns applicants that a positive result, refusal to test, failure to appear, or inability to provide a sufficient sample will result in withdrawal of the job offer. For current GDC employees, a positive result may lead to disciplinary action up to termination.

Key Topics

  • pre-employment drug testing
  • drug test notification
  • conditional employment
  • drug screening
  • urine test
  • substance abuse testing
  • employment contingency
  • positive drug test
  • drug test refusal
  • laboratory testing
  • CHRM
  • disciplinary action

Full Text

SOP 104.58
Attachment 8

8/19/20

MEMORANDUM

TO: Employee Name and SSN

FROM: Appointing Authority Name/Title

SUBJECT: DRUG TEST AWARENESS STATEMENT/NOTIFICATION
(PRE-EMPLOYMENT)

DATE: Date Being Issued

Your employment, in the position offered, is contingent upon passing a drug test.

The initial drug test will be administered on-site. If this test confirms a negative result, the pre-employment
drug test procedure is complete. If the on-site drug test cannot confirm a negative result, Human Resources
will send the urine collection out to an independent lab for further testing.

If you test "positive", expressly refuse to take the drug test, fail to appear for this test, or fail to produce a
sufficient urine sample by the specified deadline, this employment offer will be withdrawn. If you are a
current State of Georgia employee, your current agency will be contacted with the positive result by
Corrections Human Resources Management (CHRM). If you are a GDC employee, a positive test result
may result in disciplinary action, up to and including termination.

Print Employee Name

Print Employee Name Employee ID (if applicable) Employee SSN#

Employee Signature Date

Employee ID (if applicable)

Date

Retention Schedule: Upon completion, this form shall be retained permanently in the employee’s local and official personnel
file. If not hired, the form shall be retained in the Interview/Selection file for twos (2) calendar years.

Attachments (12)

  1. Sample Letter - Alcohol/Drug Suspension with Pay (Classified/Unclassified Employee) (223 words)
  2. Sample Letter - Alcohol Dismissal (Classified Employee) (175 words)
  3. Sample Letter - Alcohol Dismissal (Unclassified Employee) (166 words)
  4. Sample Letter - Drug Dismissal (Unclassified Employee) (246 words)
  5. Sample Letter Drug Dismissal (Classified Employee) (254 words)
  6. Alcohol and Drug Test Notification (Random) (270 words)
  7. Alcohol/Drug and CDL Drug Testing Log (82 words)
  8. Drug Test Awareness Statement/Notification (Pre-Employment) (220 words)
  9. On-Site Substance Abuse Screening Documentation Form (38 words)
  10. Withdrawal of Employment Offer Due to Positive Pre-Employment Drug Test (167 words)
  11. Withdrawal of Employment Offer for Refusal to Test_Failure to Remain or Appear for Pre-Employment Drug Test (190 words)
  12. Behavioral/Incident Documentation Form (for Reasonable Suspicion Drug and Alcohol Testing) (150 words)
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